Antimicrobial Stewardship in LTPAC

Now, more than ever, it is critical for consultant and senior care pharmacists to lead the way toward improving the use of antimicrobial medications in post-acute long-term care, skilled nursing facilities, and community settings. Here are a few tools from ASCP to help you lead the charge towards implementing a successful antimicrobial stewardship program in your facilities.

Controlling the Use of Antibiotics: Are You Ready?

The Consultant Pharmacist, the peer-reviewed journal of the American Society of Consultant Pharmacists (ASCP), has published an informative supplement on implementing stewardship programs to help ensure facilities will be compliant with upcoming Phase 2 regulatory guidance, which goes into effect November 28, 2017.

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Antimicrobial Stewardship Workshop

Implementing an Antimicrobial Stewardship Program in Post-Acute Long-Term Care is a 4-hour live program with interactive activities that will provide senior care pharmacists with the knowledge, tools, and strategies to lead long-term care facilities toward a functional Antimicrobial Stewardship Program that complies with regulatory requirements.

ASCP-SIDP Certificate Program

ASCP and the Society of Infectious Diseases Pharmacists (SIDP) launched a joint Long-Term Care (LTC) Antimicrobial Stewardship Certificate Program. This is a practice-based certificate program focused on the role that senior care pharmacists play in the appropriate use of antimicrobial agents in long-term care and post-acute care settings. Through online programming and live webinars, pharmacists will practice developing interventions at their practice sites that aim to improve patient/resident care and clinical outcomes, lower health care costs, and reduce antimicrobial resistance.

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AADNS-ASCP Antimicrobial Stewardship Program

The Antibiotic Stewardship Program in Long-Term Care is a virtual workshop designed for front-line and administrative nursing facility staff. Co-presented by a senior care pharmacist and nurse, faculty discusses the seven elements of infection prevention and control as outlined in federal regulation F881. Participants will learn how to establish a committed ASP interdisciplinary team, identify quality indicators for a QAPI program, and recognize medication-related problems relevant to the principles of ASP. The online program is accredited to provide 6 hours of continuing pharmacy and nursing education.

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Antimicrobial Stewardship in LTPAC Toolkit

ASCP’s Antimicrobial Stewardship in Long-Term and Post-Acute Care Toolkit will help you facilitate antimicrobial stewardship programs in your nursing facilities. The toolkit provides practical guidance on how to initiate, grow, and sustain an antimicrobial program that becomes an integral part of your facility’s Quality Assurance Improvement Program (QAPI) and ensures compliance with infection prevention regulations in the CMS Long-Term Care Final Rule.

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Up to 70% of nursing home residents receive at least one systemic antibiotic per year, with a large proportion of those prescriptions considered unnecessary or inappropriate. Overuse of antibiotics can have serious consequences in older adults, including side effects, drug interactions, the emergence of antimicrobial resistance, and C. difficile infections.

Improving the use of antibiotics to protect patients and reduce the threat of antibiotic resistance is now a national priority. In 2015, The Centers for Disease Control (CDC) published The Core Elements of Antibiotic Stewardship for Nursing Homes. This adaptation of the CDC’s Core Elements of Hospital Antibiotic Stewardship recognizes that although the elements of a stewardship program remain the same—leadership commitment, accountability, drug expertise, action, tracking, reporting, and education—implementation in a nursing facility poses some challenges.

The Centers for Medicare and Medicaid Services (CMS) has also recognized that long-term care facility residents are vulnerable to the overuse of antibiotics. The agency recently finalized a rule to improve the care and safety of residents in long-term care facilities that participate in the Medicare and Medicaid program. Included in this rule is a regulation that requires nursing homes to establish an Infection Prevention and Control Program (IPCP).

The American Society of Consultant Pharmacists developed this toolkit to help you facilitate antimicrobial stewardship programs in your nursing facilities. Using the CDC’s Core Elements of Antibiotic Stewardship for Nursing Homes (PDF) as a guide, the toolkit provides practical guidance on how to initiate, grow, and sustain an antimicrobial program that becomes an integral part of your facility’s Quality Assurance Improvement Program (QAPI) and ensures compliance with infection prevention regulations in the CMS Long-Term Care Final Rule. For more information about other ASCP educational offerings on infection prevention, please visit our Infection Prevention Practice Resource Center.

November, 2017

The CDC announced that the week of November 13, 2017 marked the 10th Annual U.S. Antibiotic Awareness Week and the new Be Antibiotics Aware: Smart Use, Best Care educational effort. U.S. Antibiotic Awareness Week (formerly Get Smart Week) is an annual one-week observance that gives participating organizations an opportunity to raise awareness of the threat of antibiotic resistance and to reinforce patient safety with medications. Be Antibiotics Aware complements U.S. Antibiotic Awareness Week by providing stakeholders with up-to-date information about the importance of antibiotic prescribing and use. The effort included the release of many educational materials for patients and providers, including fact sheets, brochures, and infographics for consumers and health care professionals. Also visit asp.com/asp to explore ASCP's tools to help lead the charge towards implementing a successful antimicrobial stewardship program in facilities.

The ASCP Antimicrobial Stewardship Toolkit contains everything you’ll need to implement a strong infection control program in your facilities, including:

  • Sample facility microbial stewardship mission statements
  • 6 sets of slides to help you educate clinical staff on:
    • Staff engagement
    • C. difficile
    • Antibiograms
    • Antimicrobial resistance
    • Unnecessary medications (F329)
    • Drug interactions
  • Sample policies and procedures
  • Quick reference sheets
  • Review of special dosing concerns
  • Review of common medication interactions
  • Antibiotic initiation criteria from Loeb and McGeer
  • Library of consultant pharmacist recommendations to facility clinical leadership
  • Antibiogram information and implementation resources
  • Facility and resident assessment forms
  • Data collection forms
  • Facility education modules and convenient 1-page “leave behind” fliers
  • Appendix of useful online resources

In addition to the ASCP Antimicrobial Toolkit, don’t forget to take advantage of the next ASCP Antimicrobial Stewardship Workshop, which will be held on Thursday, November 2. at the ASCP Annual Meeting at the Gaylord Hotel in Kissimmee, Florida!

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